HomeMy WebLinkAbout2015-00099 - adv plan review CITY OF ORONO * 2 a 1 5 - PJ 0 0 9 9 *
2750 KELLEY PARKWAY DATE ISSUED: OU23/2015
�F 4 ' ORONO, MN 55356-
� (952 249-4600 FAX: 952 249-4616
ADDRESS : 765 BRIDGEWATER DR
PIN : 33-118-23-12-0090
LEGAL DESC : STONEBAY SEVENTH ADDITION
: LOT 3 BLOCK 1
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 350,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 350,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOME
PF..RMI'I'#THIS PRE-PAYMENT IS TIED TO:2015-00098
APPLICAIYT ADVANCED PLAN REVIEW 1,744.98
TOTAL 1,744.98
WOODDALE BUILDERS INC. Payment(s)
6117 BLUE CR DR CHECK 82294 1,744.98
MINNETONKA, MN 55343-
(952)345-0543
Minnesota State License#: BUIL-BC002926 i:i iv��o' �7 onc
%''.7`i ,;ell?y Parkway
Oro�io MN 55356 952-249-46U�
OWNER RecAipt No: 3.012668 Jan 23, 2015
Stonebrook Development LLC
6117 BLUE CR DR Wooddale Buildei�s
MINNETONKA,MN 55343- Previous Balance: .OU
Permits
2015-00099 765 1.744.98
Bridgewater Dr
101-34410
AGREEMENT AND SWORN STATEMEIYT Plan Check/Site Exam Fees
- --
The work for which this permit is issued shall be performed according to TOtal: 1,744.9H
the approved plans and specifications,applicable City approvals,and the _______________
State Building Code. This permit is for only the work described and does Cheek
no[grant permission for additional or rela[ed work which requires separate Gheck No: 82294 1,744.9£i
permits. All provisions of laws and ordinances goveming this type of work Payor:
Wooddale Builders
shall be compied with whether or no[specified herein.This permit will Total Appl ied� 1,744.98
expire and become null and void if construction authorized is not -----__--.-______
commenced within 180 days of the date of issuance,or if construction is Chenye Tendered: .UO
suspended for a period of 180 days at any time af'ter work has commenced. _=______------
I'he applicant is responsible for assuring all required inspections are Ol/23/2015 01:54PM
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause. - i��
E.._. .i
�� � - - G� �l'�C�f � _
� � z� � 5 �-�--� c l , �
Applicant Permitee gnature Date [ssued�ture Date
`�p CITY OF ORONO
i
, s BUILDING PERMIT APPLICATION
FOR NEW STRUCTURES OR ADDITIONS
�0�� Ma���PO Bo�66 � Permit number. �U��`(��Q
Crystal Bay, MN 55323-0066 Date received: �- Z��-��
� �, Street Address:' e • ,
F Gti 2750 Keiley Park y t�;�r /'_�� Plan review fee: ,q C
t.qK�'SHo�� Orono, MN 5535 ��� �
Total Fee:
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us
This application form must be completed in full and all required information must be submitted.
Incomplete applications wili be returned. (Please print)
GENERAL INFORMATION: �
Job Site Address: 7(�,S �o%3 �B�°`K �' �. �,� ,' v �f//yAop,1'�e,
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes ❑ No
lf yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT I MATION:
Name: - � {
State License# � Expiration Date: 3 3 �
Phone: cell - ,g- office S - s'D 3
Mailing Address: Cit � ;,,,,.�r,.,�,,f ZIP: S'
Contact Person: c!�/w•�e T<<c, s Applicant is: Contractor / Homeowner (Circie One)
Email and/or Fax: �'�v,� � � e e �Q�/� � p�� f , o�
PROPERTY OWNER INFORMATION:
Name: .S T�,,,� 6,a,a,eiC De v C L C'
Phone(day): QS � � S 5�.��-d y3.
Address: �// � g� � � ,� D.�. City: �.��,�.� Twa..ZIP: SS 3�3
Email and/or Fax ST� v � r B.. Ge9 00 .�r �� 'L.�r�w �"o ...�-...
ARCHITECT/ ENGINEER INFORMATION:
Name: ^
Phone (day): Z. - 3�,r . p
Address: // Cit : .�....,�� Tv.�.,t',�ZI P: � ,3 y
Email and/or Fax: ^ v Q '� c wi . ....�-.
PROJECT INFORMATION: Description of project:
1.Type Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal 8�
New Construction Water Supply
❑ Single Family with Residence /
❑Addition attached garage ❑ Garage/Accessory Bldg. [.�'i'ublic Sewer
❑Accessory Building � Single Family with ❑ Deck
❑ Relocation hed arage ❑ Office/Commercial
❑ Other: (specify) [�il �� ❑ Warehouse � Private Sewer
ulti le Famil /Condo
❑ Public ❑ Storage Public Water
**Any earth movement may also require ❑ Commercial ❑ Other(specify)
MCWD review&permits. ❑ Industrial
Minnehaha Creek Watershed District MCWD ❑ Private Well
( ) ❑ Other: (specify)
18202 Minnetonka Blvd
Deephaven,MN 55391
Phone: 952-471-0590
Fax: 952-471-0682
www.minnehahacreek.or
Estimated Construction Valuation (excluding land) $ �� Q d Q � ,